NURS FPX 6021 Assessment 2 Change Strategy and Implementation

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Change Strategy and Implementation

Hypoglycemia refers to a condition resulting from reduced blood glucose in diabetic patients. It occurs mainly due to the treatment of diabetes with symptoms such as dizziness, blurred vision, sweating, shaking, and elevated heart rate. The 70-year-old African American male patient might have been taking much diabetes medication, not eating, and being depressed due to the loss of his wife. Type 2 diabetes develops due to an imbalance between blood sugar and insulin production. Common symptoms include weight loss, frequent urination, and an imbalance in blood sugar (Mouri & Badireddy, 2019). In this case, the patient has a chronic wound on the left great toe; he is non-compliant due to transportation and finances. The patient is depressed, has lost his wife, and has vision problems. 

Hypoglycemia and Type 2 Diabetes

The primary distinguishing factor for hypoglycemia is low levels of blood glucose. The condition is responsible for the patient losing consciousness (Mouri & Badireddy, 2019). Various factors contribute to the development of hypoglycemia among diabetic patients. However, the primary factor is the prolonged usage of insulin and drugs that reduce blood sugar levels (Mayo Clinic, 2020). The patient might have been misusing the drugs leading to the loss of consciousness, a symptom of hypoglycemia. These drugs rapidly lower blood glucose levels if not appropriately regulated or used in the recommended dosages (Freeman, 2019). According to the scenario, the patient’s lack of compliance with his diabetes management results from financial difficulties. Hypoglycemia may develop due to this noncompliance (Mayo Clinic, 2020). For instance, the patient may encounter periods of hypoglycemia if he cannot afford the essential snacks or regular meals to maintain stable blood sugar levels.

The patient’s unhealing wound on his left great toe may also increase the danger of hypoglycemia. Peripheral neuropathy and decreased blood flow to the extremities, which impedes wound healing, are consequences of poorly controlled diabetes (Freeman, 2019). Infection risk increases when the body is unable to heal wounds properly. In this instance, the patient’s non-healing wound might have influenced the hypoglycemia episode.

Depression and Type 2 Diabetes

Type 2 diabetes and depression have a complicated and reciprocal interaction. Various physical and mental symptoms and persistent depressive symptoms indicate that the patient has depression. According to studies, type 2 diabetes patients are likely to develop depression (Yang et al., 2023). The patient in the example just lost his wife, and he is said to be in a terrible state of depression. Grief and loss substantially negatively impact mental health and can cause depression symptoms to appear or deepen. The strain and emotional toll brought on by losing a loved one may severely impact the patient’s capacity to control his diabetes adequately. Depression can result in poor medication compliance, a lack of desire, a loss of interest in self-care activities, and bad lifestyle decisions, including inactivity or poor eating patterns (Chen et al., 2019).

The scenario also indicates that the patient has a limited budget for food and transportation. Financial difficulties can exacerbate depression symptoms by adding to emotions of misery and helplessness. Diabetes treatment and self-care might become increasingly difficult when depression and financial troubles are present (Yang et al., 2023). For the patient’s general health and diabetes control to improve, it is essential to address his depression (Chen et al., 2019). A thorough treatment program that incorporates psychotherapy, counseling, or support groups can aid the patient in overcoming despair, coping with grief, and increasing his motivation to control his diabetes effectively.

Change Strategies

The treatment strategy must involve several interventions, such as education and support, access to public transportation, and assuring collaborative care and support to manage the patient’s hypoglycemia and depression efficiently. Inform people about the significance of routine blood glucose monitoring and the symptoms of hypoglycemia. Emphasize the importance of appropriate footwear and socks in wound healing while teaching the patient self-care methods, such as basic wound care. Inform the patient about the connection between depression and diabetes and the effect that controlling depression has on maintaining overall diabetes management.

Assist the patient in applying for paratransit services to ensure reliable transportation for medical appointments and grocery shopping. Collaborate with the VA to cover the transportation fees, ensuring the patient can access necessary resources. To offer complete care and support, engage an interdisciplinary team comprising medical professionals, nurses, dietitians, and mental health specialists. Facilitate teamwork and communication to ensure a comprehensive approach to the patient’s care. To increase social support and lessen loneliness, introduce the patient to local resources such as support groups and social services.

The patient will be more active in their care if he has the knowledge and abilities to control hypoglycemia and depression. This will lead to understanding the potential side effects of drugs, treatment compliance, and improved self-management. On the other hand, addressing transportation issues will allow the patient to go to appointments, get the prescription drugs they need, and get the groceries they need. This transformation technique encourages adherence to the suggested treatment plan and enhances the patient’s well-being. An interprofessional team’s involvement enables a multifaceted approach to the patient’s care. Better clinical outcomes will result from addressing the patient’s physical and mental health demands and offering social support. Coordination among team members will guarantee a thorough and well-rounded care plan.

The change strategies aim to raise the standard of care and encourage fair access to services. The patient’s access to care is improved, resulting in a reduction in disparities. This is accomplished by removing transportation barriers through paratransit and fee coverage. Patient empowerment comes from teaching them how to care for themselves and encouraging their active engagement, promoting safety and better outcomes.

To enable the change initiatives’ successful implementation, various healthcare experts must work together. Doctors might offer medical care and modify treatment regimens following the monitoring findings. In addition to educating patients on self-care, nurses can monitor the patient’s blood glucose levels and the course of their wounds. Dietitians can provide dietary recommendations tailored to diabetes control. For the patient’s depression, mental health specialists can offer therapy and support. The patient’s likelihood of receiving successful therapy will improve with effective interprofessional communication and coordination, guaranteeing a holistic approach.

Data Table

Current OutcomesChange StrategiesExpected Outcomes
These measures ensure the patient receives effective diabetic treatment and learns how to manage his physical and mental issues effectively. For this patient, it is expected that; He will fully participate in his treatment process, including pain management. The patient adheres to effective methods of foot checks and hygiene. The patient actively participates in his physical therapy sessions. The patient has an active follow-up mechanism. Various measures must be implemented to ensure the patient gets effective care that will help manage his condition and improve the outcomes. These measures include: Providing educational support and teaching on diabetes management concerning foot hygiene and proper shoes. Referrals to outpatient podiatry and physical therapy. Scheduling pain management appointments/follow-ups and advice on the effectiveness of music therapy to address depressive symptoms.These measures ensure the patient receives effective diabetic treatment and learns how to manage his physical and mental issues effectively. For this patient, it is expected that; He will fully participate in his treatment process, including pain management. The patient adheres to effective methods of foot checks and hygiene. The patient actively participates in his physical therapy sessions. The patient has an active follow-up mechanism. 

References

Chen, F., Wei, G., Wang, Y., Liu, T., Huang, T., Wei, Q., Ma, G., & Wang, D. (2019). Risk factors for depression in elderly diabetic patients and the effect of metformin on the condition. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7392-y

Freeman, J. (2019). Management of hypoglycemia in older adults with type 2 diabetes. Postgraduate Medicine, 131(4), 241–250. https://doi.org/10.1080/00325481.2019.1578590

Mayo Clinic. (2020, March 13). Hypoglycemia – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

Mouri, Mi., & Badireddy, M. (2019). Hyperglycemia. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430900/

Yang, H., Wu, F., Gui, M., Cheng, Y., & Zhang, L. (2023). The role of medication adherence in the association between depressive symptoms and quality of life in older adults with type 2 diabetes mellitus. BMC Geriatrics, 23(1). https://doi.org/10.1186/s12877-023-03929-8

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